Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $351.22 / $706.41	Facility		$75.86	$351.22	$706.41
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.50 / $12.07 / $23.67	Facility	26	$7.50	$12.07	$23.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.31 / $417.81 / $835.62	Facility	TC	$28.31	$417.81	$835.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.71 / $32.95 / $61.40	Professional		$14.71	$32.95	$61.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $8.42 / $24.03	Professional	26	$7.23	$8.42	$24.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.43 / $28.48 / $89.29	Professional	50	$28.43	$28.48	$89.29
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.34 / $16.05 / $18.63	Professional	52	$12.34	$16.05	$18.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.80 / $27.37 / $48.42	Professional	TC	$21.80	$27.37	$48.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.11 / $140.12 / $183.32	Facility		$111.11	$140.12	$183.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.82 / $41.06 / $60.02	Professional		$29.82	$41.06	$60.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $9.55 / $14.43	Professional	26	$7.51	$9.55	$14.43
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $44.70 / $61.73 / $90.19	Professional	50	$44.70	$61.73	$90.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.54 / $31.73 / $46.10	Professional	TC	$22.54	$31.73	$46.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.21 / $40.67 / $89.49	Professional		$35.21	$40.67	$89.49
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.86 / $9.31 / $11.82	Professional	26	$8.86	$9.31	$11.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.61 / $29.10 / $36.38	Professional	TC	$27.61	$29.10	$36.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.10 / $104.86 / $500.00	Facility		$61.10	$104.86	$500.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $31.68 / $31.68 / $31.68	Facility	TC	$31.68	$31.68	$31.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.76 / $40.43 / $75.68	Professional		$27.76	$40.43	$75.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $10.91 / $18.75	Professional	26	$6.74	$10.91	$18.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.82 / $29.50 / $57.66	Professional	TC	$20.82	$29.50	$57.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.08 / $42.10 / $51.59	Professional		$35.08	$42.10	$51.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $9.33 / $11.26	Professional	26	$7.56	$9.33	$11.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.52 / $33.03 / $40.47	Professional	TC	$27.52	$33.03	$40.47
Medcost Facility/Professional Facility Modifier Low / Median / High Price $30.21 / $46.55 / $65.53	Facility		$30.21	$46.55	$65.53
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.15 / $17.00 / $26.00	Facility	26	$12.15	$17.00	$26.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $31.47 / $46.95 / $72.98	Facility	TC	$31.47	$46.95	$72.98
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.09 / $33.00 / $58.00	Professional		$11.09	$33.00	$58.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $9.85 / $33.10 / $65.14	Facility		$9.85	$33.10	$65.14
Sentara Facility/Professional Professional Modifier Low / Median / High Price $12.01 / $39.40 / $80.70	Professional		$12.01	$39.40	$80.70
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $11.92 / $18.88	Professional	26	$8.66	$11.92	$18.88
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $26.07 / $37.13 / $60.58	Professional	TC	$26.07	$37.13	$60.58
United Facility/Professional Facility Modifier Low / Median / High Price $10.31 / $28.96 / $185.87	Facility		$10.31	$28.96	$185.87
United Facility/Professional Professional Modifier Low / Median / High Price $27.55 / $40.40 / $64.39	Professional		$27.55	$40.40	$64.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.77 / $10.68 / $16.75	Professional	26	$6.77	$10.68	$16.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.38 / $30.30 / $49.36	Professional	TC	$20.38	$30.30	$49.36